Archives for Medications

Coping with Depression

Celebrating a decade, depression-free

I celebrate three dates every year: August 27, 1998 - my sober birthday; December 18, 19?? - my belly-button birthday and April 26, 2005 the day my depression swallowed me whole.

It's hard to believe it's been 10 years since my last major depression. I have had ups and downs but for 10 years now, there has been a floor below me and ceiling above me. I credit my medications for those gifts.

When I first started taking them...
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Bipolar

Pulling the plug on my mania and CrossFit

Mania is a luscious, exhilarating state of mind. All the fatigue and weariness in your bones and soul vaporizes. Your muscles feel bigger and stronger and ready to strike. Your thoughts are clear and brilliant. You are like a racehorse in the gate, wide-eyed and pawing at the ground with your hoof. There is no off-switch.

Medications give you a dimmer but you still have to have the desire and willingness to use it beyond the involuntary waning it induces.  You have to make the decision to turn the dimmer nob further to the left.

That is where I find myself today - turning the nob to the left. I am - of my own volition - taking my life down a notch. I don't want to but I need to. It's hard for me to believe I'm doing this. But years of therapy and the wisdom that comes with 56-years of f#*king up my life have taught me it's time.

I have bipolar II - called hypomania. It's bipolar lite. My ups and downs are not nearly as intense as those poor souls with bipolar I. Of course, fueling my mania with drugs and alcohol for decades enhanced those ups and downs. But I know I am blessed to have this lesser form of bipolar.
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dreams and depression

60 hours without my antidepressants?

I went to visit my daughter this weekend. She lives about 2-1/5 hours away. Half way there I realized I had forgotten my medications.

I take three medications, two antidepressants and mood-stabilizer. I have been taking them for 7 years. Every day. Morning. Night. I don't mess around and skip a day here or there. I take them without fail.

I did the math in my head. I took my last dose at 7 am Friday. I was not planning on getting home until at least 7 pm on Sunday. That would be 60 hours without my medications. Once I forgot to order a three-month supply of one of my antidepressants and ran out for about three days so I knew what it felt like to skip a few days without one of the medications.

I had a headache - like my head was simultaneously going to implode and explode. My thoughts were thick, like I was thinking in mud. I was tired.

I had never gone as long as 60 hours without all three. I knew I would feel some kind of withdrawal. I just didn't know what to expect.

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Alcoholism

Mentally ill now and forever…amen.

Every now and then I get a glimpse of what my mental illnesses look like.

It's been a long time. I have taken my medications without fail for years.  I exercise, eat healthy foods, get as much sleep as I can, visit my psych-nurse practitioner every three months and I get on my knees every night and thank God for my sobriety. In other word, I do what I am told - an unnatural act for me.

But for the last two weeks I have been under an unconscionable amount of stress. I say "unconscionable" because I allowed it to happen.

As a reporter for a daily newspaper, I am accustomed to stress. For nearly 30 years I have lived with a deadline hanging over my head. I took six weeks off to have a baby, 8 weeks for my last major depression but other than the one- or two-week vacations, I have had a deadline over my head.

Recently, I accepted  an assignment which today I realize I should not  have done. I agreed to leave my home and my dog, suspend my exercise routine and healthy eating habits and forego nights of 8-hours of sleep to cover the Florida legislature's last two-weeks in session.

I did this once before, nearly 30 years ago when reporters were only expected to write a story for the newspaper. Now, we must also Tweet, blog and make videos. Despite my degree in political science, after 30+ years in journalism, I'm kinda disallusioned with politics.

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General

Botox: The new antidepressant?

Halle-freakin'-lujah!

We have a couple more studies that suggest that paralyzing key facial muscles with Botox can reduce the symptoms of depression.

In a recent 24-week randomized double-blind placebo-controlled study, done by Michelle Magid, MD, clinical associate professor of psychiatry at the University of Texas, 30 participants with depressive symptoms were randomized and give injections of Botox or a placebo between the eyebrows (which happens to be exactly where I need it.)

The men were injected with 39 units of botulinum and the women were injected with 29 units. At week 12, the placebo group crossed over to treatment, and the treatment group crossed over to placebo.Participants were evaluated at weeks 0, 3, 6, 12, 15, 18, and 24. The primary outcome was a reduction from baseline of at least 50% in the 21-item Hamilton Depression Rating Scale score.

In a yet-to-be-published study in the in the Journal of Psychiatric Research, Eric Finzi, a cosmetic dermatologist, and Norman Rosenthal, a professor of psychiatry at Georgetown Medical School, randomly assigned a group of 74 patients with major depression to receive either Botox or saline injections in the forehead muscles that enable us to frown.

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General

Worried? Quality of evidence FDA uses to approve medications varies widely

An article published in today's issue of the Journal of the American Medical Association has me kind of freaked out.

According to a press release advancing the article, Wide Variation Found in Quality of Evidence Used By FDA For Approval of New Drugs:

“Many patients and physicians assume that the safety and effectiveness of newly approved therapeutic agents is well understood; however, the strength of the clinical trial evidence supporting approval decisions by the U.S. FDA has not been evaluated.”

As someone who has been on not one, not two but a cocktail of  three medications - two anti-depressants and a mood stabilizer -  for more than seven years I am one of those persons who assumed that the safety and effectiveness of the drugs I take were established by the gold standard for evaluation: the randomized, double-blind study.

Apparently not. Dr. Joseph Ross and Nicholas Downing from the Yale University School of Medicine examined every FDA drug approval from 2005-2012. Their study included how many clinical trials were submitted to support the approval, how long the trials lasted, how many patients were studied and the outcomes used to define the drug's effects and safety.
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Coping with Depression

How’s that New Year’s resolution working for you?

I don't do resolutions but apparently a lot of people do because the gym was packed this morning.

If something needs to change, I change it. Relying on a number on a calender has never worked for me. Trust me. I've tried it. You can ask any alcoholic and they will tell you they have set deadlines and then either missed them or got sober for a few weeks and then they're back at it.

It's the same with dieting. If you can go ON a diet, you can go OFF a diet. You want to lose weight or quit smoking or drinking, you just do it - not because it's a certain day of the year. Because it needs to be done and every cell in your body is convinced of that truth. In the words of the philosophers at Nike: Just do it.

Of course if you are as hard headed as I am, it may take some time to convince yourself that you really need to make a change. In fact, I brain has concocted truly ridiculous arguments  to prove to myself that I didn't need to quit drinking, take antidepressants or see a therapist.

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Alcoholism

Free mental health care: Moving beyond the freeloader mentality

Every Saturday morning I refill my pink pill box: S-M-T-W-T-F-S. I have been doing this for years. Three different medications. One of this pill. One of that pill. One-and-a-half of those pills. Every morning and every night, I take my meds. It's like brushing my teeth - just something I do when I wake up and before I go to bed.

My meds. I go weeks without giving a thought to my meds. I just take them. My life is good. No more hopeless black holes or vibrating with energy like a wide-eyed racehorse pawing at the dirt in the starting gate. Nice and steady. I have grown used to it and I really, really like it.

So, when something comes along that has the potential to seriously disrupt my balance, I tend to freak out. Anxiety is the enemy. Drama is the enemy. I have made enough enemies in my life. I don't need to make anymore.

There are three things that scare the hell out of me: Sharks. Being trapped in a car after an accident and cut out with the jaws of life; unemployment. As long as I stay out of the ocean and drive safely, I'm in good shape. Right now, unemployment is beyond my control.

And I like to be in control.
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Dual-Diagnosis

Should This Doctor be Billed for Supplying Addicts with Drugs?

In July I blogged about Dr. John Christensen, a West Palm Beach doctor who was charged with two counts of first-degree murder for the overdose deaths of two patients he treated at his clinics, which investigators described as "pill mills."

Now we have learned that prosecutors intend to seek the death penalty against Christensen. 

I am not a fan of the death penalty but not for the usual reasons. As someone who has sat through murder trials, walked down death row, interviewed condemned killers, actually sat in the electric chair and witnessed an execution - I have decided that capital punishment is futile, immoral and a monumental waste of tax-dollars.

If you really want to punish someone, lock them in a 6 x 9 foot cell for 30 or 40 years. The average length of stay on Florida's death row is 13 years and many killers will tell you they would prefer to die than live out their lives in a box.

Although research has shown that the death penalty is not a deterrent, I suspect that executing a physician who knowingly prescribed massive doses of drugs to an addict who then overdosed, would be a deterrent to other physicians. A really, really big deterrent.

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